Thursday, August 15, 2013

According to the president and his minions, this fall you will be able to pick a health insurance

plan from any number of offerings on the #Obamacare exchange. The pitch is, it will be just like shopping on Travelocity or Amazon.Really?Do either of those sites require full disclosure of prior income and tax information as well as a "best estimate" of future earnings? Am I required to invest 45 minutes of my time (according to CBO) to undergo a financial colonoscopy before I even BEGIN to shop for an airline ticket or book?

Mr. Nowak, a 48-year-old Indianapolis medical-spa owner, likes WellPoint. But he has been seeing an Indiana University-affiliated physician for five years, and "when you get a trust with a doctor, you want to stick with them," he said.

WSJ OnlineIf Mr. Nowak buys a policy from Anthem Blue Cross (his current insurance carrier), doctors affiliated with Indiana University Health system and their 19 hospitals will not be in network for exchange based policies. The Blue plan will be an HMO which means no coverage for non-emergency services administered outside the network.Early estimates are that roughly HALF the plans offered on the exchange will be HMO contracts that severely limit the number of available par providers imposes severe financial penalties when consumers voluntarily use non-par providers.Translation - you pay for everything out of pocket for non-par services.

Insurers are betting that consumers who buy plans on the exchanges will be willing to trade some choice and flexibility in order to get cheaper premiums. Smaller networks of providers generally translate to lower premiums, because insurers can negotiate discounts with health-care providers who will then have less competition for patients within the network.

In other words, price sells.At least that is the game plan.If you live in Los Angeles don't count on using UCLA Medical Center or Vanderbilt if you are in the Nashville area.In some parts of Georgia, your only plan choice will be Blue Cross if you buy on the exchange. That may mean driving 100 miles or more to see a doctor or receive treatment in a par hospital.Sound like a #trainwreck yet?Or you can buy OFF exchange and have a greater choice of plans and providers.So buying on the exchange is like buying an airline ticket online?Hardly.Don't like the hand you are dealt? Too bad. Time to ante up or fold.

According to the president and his minions, this fall you will be able to pick a health insurance

plan from any number of offerings on the #Obamacare exchange. The pitch is, it will be just like shopping on Travelocity or Amazon.Really?Do either of those sites require full disclosure of prior income and tax information as well as a "best estimate" of future earnings? Am I required to invest 45 minutes of my time (according to CBO) to undergo a financial colonoscopy before I even BEGIN to shop for an airline ticket or book?

Mr. Nowak, a 48-year-old Indianapolis medical-spa owner, likes WellPoint. But he has been seeing an Indiana University-affiliated physician for five years, and "when you get a trust with a doctor, you want to stick with them," he said.

WSJ OnlineIf Mr. Nowak buys a policy from Anthem Blue Cross (his current insurance carrier), doctors affiliated with Indiana University Health system and their 19 hospitals will not be in network for exchange based policies. The Blue plan will be an HMO which means no coverage for non-emergency services administered outside the network.Early estimates are that roughly HALF the plans offered on the exchange will be HMO contracts that severely limit the number of available par providers imposes severe financial penalties when consumers voluntarily use non-par providers.Translation - you pay for everything out of pocket for non-par services.

Insurers are betting that consumers who buy plans on the exchanges will be willing to trade some choice and flexibility in order to get cheaper premiums. Smaller networks of providers generally translate to lower premiums, because insurers can negotiate discounts with health-care providers who will then have less competition for patients within the network.

In other words, price sells.At least that is the game plan.If you live in Los Angeles don't count on using UCLA Medical Center or Vanderbilt if you are in the Nashville area.In some parts of Georgia, your only plan choice will be Blue Cross if you buy on the exchange. That may mean driving 100 miles or more to see a doctor or receive treatment in a par hospital.Sound like a #trainwreck yet?Or you can buy OFF exchange and have a greater choice of plans and providers.So buying on the exchange is like buying an airline ticket online?Hardly.Don't like the hand you are dealt? Too bad. Time to ante up or fold.